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Individual

LISA R. MANCL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS

Contact information

Practice address
1959 NE PACIFIC ST, SEATTLE, WA 98195-0001
(206) 685-4692
(206) 543-5771
Mailing address
PO BOX 24366, SEATTLE, WA 98124-0366
(206) 598-0502
(206) 598-0516

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
LD00002371
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
77384U
REGENCE BLUESHIELD
WA
05
8341711
WA
Enumeration date
07/24/2006
Last updated
10/12/2007
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